PA Guild of Professional
Chimney Sweeps Membership Application
Name:
Company
Name:
Address:
City:
State:
Zip code:
County:
Business
Phone:
Home
Phone:
Fax
Number:
Email
Address
Nature of
Business
Type of
Business:
Date of Birth
Years in
Business
Are you
Part-time
Full-time
How many people are
directly responsible for chimney cleaning in your business?
Business
affiliations: (Better Business Bureau, Chamber of
Commerce, etc.)
CSIA Certification
Number
Other
Testing
Will you try to
attend all business meetings and conventions held by the
Guild?
Yes No
Are you willing to
participate in committees or in an advisory capacity to
help and assist your Guild?
Yes No
Recognizing the
importance of the Guild Membership in the growth of the
profession of Chimney Sweeps and agreeing with the Purpose
of the Pensylvania Guild of Professional Chimney Sweeps, I
hereby apply for membership.
Yes No
Please contact me
I'd like to know
more about joining the Guild
I will send
a check for:
$
100.00 per year
to join the Guild.
Please print form and mail
with payment to:
PA Guild
of Professional Chimney Sweeps Tracy Anderson
426 Hillside Rd
New Cumberland, PA 17070
